Endoscopic sinus surgery is the surgical procedure used in the management of chronic rhinosinusitis, benign nasal tumours as well as selected malignant nasal tumours as well as in diseases of the orbit. One of the challenges in endoscopic sinus surgery is proper visualization of anatomical landmarks and structures, due to the high vascularity of nose and paranasal sinuses. In addition to this, general anaesthesia causes an overall vasodilatory effect in the body, leading to a hyperaemic nasal mucosa. Adrenaline used either topically or by infiltration, to achieve hemostasis, has become popular as it is inexpensive and easily available in every hospital. Topical adrenaline in concentration of 1:1000, is the most commonly used vasoconstrictor for nasal packing currently. It aids in achieving haemostasis and prolonging the duration of action of local anaesthetics when added with them. By acting on both alpha and beta adrenergic receptors of the body, adrenaline produces effects like increased vasoconstriction (locally and systemically) and increased heart rate, cardiac output and contractility.These physiological effects of adrenaline pose a risk of complications like  hypertension, coronary ischemia, ventricular dysrhythmias and cerebral haemorrhage etc.

The literature regarding systemic absorption of adrenaline and comparing different concentrations of adrenaline and the effects it has on surgical visibility and hemodynamic parameters is very limited. Thus, this study is being done to assess the systemic absorption of adrenaline present in nasal packs, the haemodynamic effects caused by it and the improvement in surgical field obtained when two different concentrations of adrenaline are used.